Behavioral Health Helpdesk Self-Service Tickets

Submit Ticket to Behavioral Health

** Mandatory fields are highlighted and preceded by an asterisk

*Brief Description:

Priority: Status:

Ticket Information
*Choose Applications:			*Choose Modules:
*Choose Clients Service Population?:			What is the page name you are having trouble with:

What is the People ID that you are anchored on?:			What Organization ID are you anchored on?:

If you know it is one of these issues please check below
Is this a Change Request:			Is this a problem with application:
Is this a Training Issue:			Is this a Performance issue:

Access Issues:
I Don't Have Access to Client:			I Need My Password Reset:
I Don't Have Access to Organization:			I need to Delete User:
I Need Access to EIS:			I need a Profile Change:
Link to Forms for Access(Opens in New Window)
I Need Access to Types:			Do you need a data change:

For Internal Staff - If Performance is Slow follow these Steps:
Check Daily Status for performance issues:
Daily Status (Opens in New Window)
Check Reports Server for performance issues:
report server 1 (Opens in New Window)
report server 2 (Opens in New Window)

Report Issues:
Issue on Report Number:			Choose which this report is on::
Request new report, please choose which format:

Forms for Report Request (Look on Left side of page) (Opens in New Window)

If you are having problems in the Assessment Module, please fill out below:
Problem with which Assessment ID:			Problem on what Type of Assessment:

Contact Information


*First Name:		*Last Name:
*Phone:		Cell Phone:
Beeper Number:		*Email Address:
Address:
City:		Department:
Provider:

Description:

Be sure to click the submit button only once. A separate Ticket will be entered each time the button is clicked.

Click the SUBMIT button to send your Request. There is no need to reply to this email. You will receive an email confirmation if your Request is successfully registered. Please contact Wendy.Christain@maine.gov if you experience problems using this form.

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Behavioral Health Helpdesk Self-Service Tickets

Submit Ticket to Behavioral Health

Ticket Information

If you know it is one of these issues please check below

Access Issues:

For Internal Staff - If Performance is Slow follow these Steps:

Check Daily Status for performance issues:

Check Reports Server for performance issues:

Report Issues:

If you are having problems in the Assessment Module, please fill out below:

Contact Information

Description: